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Metastatic Breast Cancer

Advanced. Metastatic. Stage 4. You may hear any of these words when you get a breast cancer diagnosis. And they all mean the same thing.

The cancer has spread (metastasized) outside of your breast to other parts of your body. Like your bones, liver, brain or lungs. These organs now have breast cancer cells in them. Learning you have metastatic breast cancer can be unsettling. But when you get this diagnosis, you’ll want the best, most experienced care.

Cleveland Clinic is nationally known for breast cancer diagnosis and treatment. Our team of expert breast health providers treats all breast cancers, which range from benign (noncancerous), high-risk conditions to aggressive cancer that’s spread. And we know cancer can also affect your emotional well-being. We’re here to help you feel more comfortable in all ways as you make this unfamiliar journey.

Why Choose Cleveland Clinic for Metastatic Breast Cancer Care?

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Caring Approach:

Going through cancer treatment can make you (and your family) feel all kinds of things. Getting cancer information can help you navigate the expected — and unexpected. Our team is here with caring support and guidance starting when you reach out to us.

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Skilled collaborative providers:

At Cleveland Clinic, we make sure all your healthcare needs are met. This includes creating a personalized care team. We handpick providers from different specialties based on your unique diagnosis, so you get the most comprehensive care possible. Your team works together to build a treatment plan that keeps you at the center of your care. Meet our team.

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Innovation and research:

Our providers constantly look for new, better ways to diagnose and treat all types of breast cancer. This means you have access to the latest clinical trials (the latest experimental therapy that may not be FDA approved) and treatments that aren’t widely available. We’ve also developed a breast cancer vaccine — a treatment that we’re continuing to study further.

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Virtual visits:

Not feeling great? Rather stay curled up on the couch than drive to an appointment? Virtual visits are a convenient alternative to seeing your provider in person. You’ll get the same expert care but from the comfort of home using your smartphone, computer or tablet.

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National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Diagnosing Metastatic Breast Cancer at Cleveland Clinic

Many times, cancer cells will stay where they start growing (primary location) — in this case, your breast.

But if the cells grow and multiply quickly (aggressively), they can move out of your breast and travel into nearby lymph nodes or blood vessels. From there, they can travel to other parts of your body. And small breast cancer tumors can grow in those places.

 There are two different types of metastatic breast cancer:

  • De novo metastatic breast cancer: Cancer has already spread to other parts of your body when it’s first diagnosed.
  • Distant recurrence: This is diagnosed after the original breast cancer treatment. A few cells start growing abnormally again (cancer recurrence) — and spread outside your breast. This is the most common type of breast cancer metastasis.

Metastatic breast cancer symptoms vary based on where it’s growing. If it’s spread to your bones, you might have ongoing pain and swelling. Or bones that break easily. If it’s in your liver, you might have yellowing in your eyes and skin or stomach pain. Brain metastases often cause headaches, nausea and even seizures or personality changes. All of these are signs that you’ll want to get things checked out.

What to expect at your first visit

Going to an appointment to talk about having cancer can feel stressful. But your provider will make sure you’re comfortable telling them what’s been going on.

It’s important to share if you have symptoms and for how long you’ve had them. Your provider will also want to know about other health conditions you may have. And if you or anyone in your family have had other cancers.

During this visit, your provider will also go over what to expect from treatment. They’ll do physical and breast exams. And they’ll order tests to help them confirm a diagnosis.

Testing for metastatic breast cancer

We use several blood tests for cancer, like a complete blood count (CBC) and comprehensive metabolic panel (CMP) to see if the cancer has spread.

We may also test for tumor markers — something your cells make when you have cancer. Tumor markers for breast cancer are called CA (cancer antigens) 15-3 and 27-29. There’s also a newer blood test for cancer called a circulating tumor test. This looks for cancer cells moving through your bloodstream.

Other tumor tests include ones to look for genetic changes (gene mutations) and what kind of receptors the cells have. Receptors are proteins growing on the cell surface. They attract and connect with hormones and other proteins. And they influence how cells grow, multiply and react to breast cancer treatment. The three receptors are estrogen and progesterone and the protein HER-2/neu.

Your provider will also order imaging tests to get a closer look at your breasts and other organs, like:

Depending on what the imaging tests show, we may check your lungs with a test called a bronchoscopy. Or we might do tests called “taps” to remove fluid from an area that looks suspicious. For example, we can use a spinal tap (lumbar puncture) to remove spinal fluid, a pleural tap (thoracentesis) to remove fluid from your lungs or an abdominal tap to remove fluid from your abdomen (also known as ascites). If we see what looks like abnormal tissue, we’ll remove it and do a biopsy to look for cancerous cells.

Second Opinions for Metastatic Breast Cancer

A metastatic breast cancer diagnosis can change your life in seconds. And while it might be hard to wrap your head around everything, one thing is certain. You want to be sure you have the best providers by your side as you go through treatment. That’s why we encourage second opinions.

Second opinions can help you feel more in control of your care. We work to schedule an appointment for you as soon as possible. Our expert providers will go over your test results and talk with you about treatment options. And they’ll make sure to listen to your concerns and answer any questions you have. Our team is here to help you feel more confident about your treatment.

Meet Our Metastatic Breast Cancer Team

If you choose Cleveland Clinic, you’ll have peace of mind knowing you have the experience of providers from different specialties working together to confirm your diagnosis and build a highly personalized treatment plan. Depending on where the cancer has metastasized, your care team may include:

Other specialists that may be involved in your care include:


We work as one team — providing expert care at convenient locations throughout Northeast Ohio and Florida.

Treating Metastatic Breast Cancer at Cleveland Clinic

Metastatic breast cancer treatment aims to shrink tumors, slow their growth and improve symptoms. Your personalized treatment plan focuses on where the cancer has spread, how the cancer cells behave (tumor biology) and if you’ve had breast cancer treatment in the past.

The main treatment we use is systemic therapy. This sends medications into your bloodstream to reach cancer cells throughout your body. This could include a combination of:

As you go through treatment, we’ll keep an eye on how well the cancer responds to it and how you respond to the side effects. Treatment for metastatic cancer is often ongoing. So, we want to be sure you have the best treatment for your needs.

Surgery isn’t effective once the cancer has spread to other areas. The same holds true for radiation therapy. But you may have surgery to help with any cancer-related symptoms, like broken bones, caused by metastases. Or you may have radiation to help with pain relief or slow cancer growth in a specific part of your body and in your breast (breast wounds, breast pain, breast bleeding).

Living with Metastatic Breast Cancer

Living with metastatic breast cancer may sometimes feel overwhelming. Treatment is ongoing and may cause side effects like fatigue and nausea. But there are many ways to continue living life to the fullest. Your care team is here to help you manage your condition, physically and emotionally.

That’s one of the reasons why cancer treatment follow-up care is so important. You’ll see your care team every few months so they can check your progress. They’ll talk with you about how you’re feeling and will do a physical exam. They’ll also do tests to see how you’re responding to treatment.

This helps them figure out if you’ve gone into remission, which means you may have fewer cancer signs and symptoms. Your quality of life plays a big part in this decision. It’s important to understand that having or stopping treatment is up to you. There may be situations during your treatment journey where you may need a break from your treatment. If that’s the case, your team will discuss that with you. Your care team is here to help you decide what’s best.

Taking the Next Step

There’s a lot to consider when you find out you have metastatic breast cancer. Treatment will likely be ongoing. And, sometimes, you just aren’t going to feel like yourself. We’re here to help you through what it takes to live with metastatic breast cancer. From the latest treatments to supporting your physical and emotional well-being, our expert, caring providers want to make sure you feel as good as possible. We’re here to help you keep moving forward with your life.


Metastatic breast cancer treatment takes commitment. Cleveland Clinic is here to help you get expert, personalized and compassionate care.


Metastatic breast cancer treatment takes commitment. Cleveland Clinic is here to help you get expert, personalized and compassionate care.

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Learning you have cancer can be stressful, shocking and challenging. From the moment you get the news, you're a survivor. As you face the challenges that go along with cancer treatment and recovery — physical and emotional — we’ll be right there with you.

At Cleveland Clinic, survivorship care is one part of your journey. We offer a wide range of services, resources, clinics and support groups to help with any physical, emotional, financial and spiritual needs you might have related to your cancer diagnosis. Lending a helping hand along the way, we want you to not only survive, but thrive on this journey and beyond.

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